David Kurtzman's dental office in Marietta, Georgia, a suburb of Atlanta, is a light, inviting mix of blond wood and blue upholstery. Its welcoming feel goes along with the nature of his practice. Dr. Kurtzman, a tall, lanky man with curly brown hair and a quick smile, is a general dentist who treats clients with special needs. His team members and many of his patients affectionately call him, "DK."

"It's a practice that takes people who can't be served or won't be served at traditional practices - people with developmental disabilities; medical problems that make it either unsafe or impossible to treat at another office; or people with fears and anxieties," he says. Among those he treats are patients with autism, cerebral palsy, Lou Gehrig's disease, severe gagging, and Alzheimer's.

Zigs and Zags

Dr. Kurtzman has taken a few zigs and zags during his career to arrive where he is today. He was a community organizer, working to secure adequate health care for rural areas in North Georgia, and also worked as a scrub nurse.

A native of Brooklyn, he was always gifted with his hands; to this day he is a talented artist and skilled craftsman who enjoys cartooning and calligraphy, and who once assembled a British sports car.

Dr. Kurtzman graduated from the Emory School of Dentistry in Atlanta before returning to New York, where he completed a hospital-based rotating internship at Brooklyn Jewish Hospital. He particularly liked doing anesthesia, and continued to work in the O.R. The nights he was on call, he covered facial trauma as well as dental trauma. He also practiced a bit of "secret dentistry," using the dental clinic after midnight so he could provide free care to the other medical residents.

Despite his Brooklyn roots, Dr. Kurtzman realized he had grown a strong affinity for the South, so he moved back to Atlanta and earned his fellowship in The Academy of General Dentistry. In 1982, he opened a traditional practice that included hospital dentistry.

Over the years, his practice grew into a volume business, with four rooms, seven staff members, and four part-time hygienists. "I did restorative, cosmetic, the gamut," he recalls. Eighteen years later, he faced a personal crisis in both his marriage and his work. Unhappy and unfulfilled, he decided to give special-needs dentistry a try.

Looking back, he says, "It kind of found me and I found that I liked it. It was different; it was rewarding."

Dr. Kurtzman stresses that there is no formula for handling special-needs clients - it's a matter of experience and a great deal of patience. "Over the years, just seeing the clients, speaking with groups and families with individuals with special needs, and kind of trial-and-error, we came upon our way of dealing [with it]," he says.

One Patient at a Time

"Step number one is my assumption that most behaviors I run into are because they are afraid. By creating as much safety as possible, I've been able to help. Second, is to treat everyone as a unique human being, listening to and validating their anxieties. When I relate to them as humans, they do really well."

Today, Dr. Kurtzman's clients are a mix of traditional and special-needs individuals. Each week, he dedicates a half-day to screening special-needs clients and spends a full day in the operating room at the Wellstar Kennestone Hospital located just across the street, treating those with special needs.

"We also do 20% to 30% normal day-to-day dentistry with people with fears and anxieties," he says. "The rest are people who prefer a smaller, more personalized practice."

One day someone said, 'you're referring out so many patients a month. How much is that costing you and how much of a hassle is it to them?'

On his website, Dr. Kurtzman proudly notes that he schedules only a single patient at a time; he is no longer running from one room to the next to see clients. Taking a holistic approach to each patient - "respecting the mind, body, and spirit of each client according to the personality, health goals and desires of that person" - Dr. Kurtzman relies on a variety of psychological and sedation methods to help his patients overcome their anxieties.

When the situation calls for it, Dr. Kurtzman is willing to take unorthodox steps to serve his clients, such as injecting a patient in the parking lot and then carrying him up to the OR in order to fix his teeth.

In his office, Dr. Kurtzman relies on oral sedation dentistry on a regular basis.

"Incorporating [oral] sedation came about in one of those trial-and-error type things. For years, if anybody needed [office] sedation, I would refer it out. One day someone said, 'you're referring out so many patients a month. How much is that costing you and how much of a hassle is it to them? You might want to think about this.' So I took a course on oral sedation [offered by DOCS Education]. I went to the weekend course, and it was outlined and structured in such a way that made it really easy for me to understand and incorporate. I tried it, and it worked great. It allows me to see more people with more levels of anxiety than I could before."

An Island in an Ocean

Dr. Kurtzman continues to do community work, though he left behind organizing years ago. He volunteers one day a month at Atlanta's Ben Massell Dental Clinic, the oldest free dental clinic in the country. "The clinic has been my cause célébre since I was in dental school, when we had to go there because it was part of our rotation," he says. "I'm on the board of directors, and I'm really proud to be part of it."

For other dentists who wonder about getting involved in special-needs care, Dr. Kurtzman has this to say: "Each one of us practices in a way, or should, that is most comfortable and most meaningful to us. If a client causes you and your staff anxiety - if it ruins your office flow - in the best interests of that client, refer it to someone who deals with that. If it's something you're interested in, realize that the time to let this person feel safe, to trust, to attach to your office, to let go of some of their defenses, is necessary. There's no way around it. But if you find that whatever type of dentistry you're practicing does not fulfill your wants and your desires, this might be something that could interest you."

Dr. Kurtzman, now 62 years old, is thinking about a "succession plan," but he hasn't found the right person to take over his practice. Special needs dentists are a small group that he describes as an "island in an ocean," so qualified professionals are few and far between.

Until he finds someone, he remains open for business.

Editor's Note: Since DOCS Education's founding in 1999, more than 22,000 dentists have completed one or more DOCS Education courses. That is a large and distinguished community.

Many of our doctors have gone on to build impressive practices offering fearful and anxious patients a means to restore and maintain their oral health. Thanks to DOCS Education-trained professionals, millions of people have enjoyed - and continue to enjoy - the benefits of dentistry without panic or pain.

While every dentist who provides patients with safe, effective sedation following the proprietary DOCS Education protocols deserves a salute, some of our most distinguished graduates have earned the hallmark of "Best in the Nation" - a designation our faculty and staff bestow on fewer than 1-in-every-200 of our alumni.

If you know of a DOCS Education alumnus who merits inclusion in our awards program, please email us at Nominations@DOCSEducation.com. In 100 words or less, tell us why this dentist is among the elite of the elite. Please be sure to include your name and contact information, should we have any questions.

By the way, feel free to nominate yourself. Who knows better than you what an outstanding job you're doing?

Contributing writer Nancy LeBrun is a veteran health and wellness writer, and an Emmy-winning video producer. A former editorial staff member at WebMD, she is based in Roswell, GA.

The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.